Buffalo Hump Liposuction

Conveniently located to serve the areas of Roseville, Antelope, Citrus Heights, Rocklin and Sacramento, CA

Also referred to as a dorsocervical fat pad, a buffalo hump is an accumulation of subcutaneous fat at the base of the neck and between the shoulders. Because of its placement, there are no specific exercises or fat-burning strategies that can effectively target this condition. That is why Dr. Jack Friedlander and his NorCal Lipo team offer buffalo hump liposuction. With this procedure, Dr. Friedlander can safely remove the projecting fat pad from the base of the neck to give the patient a slimmer upper back. To see how our NorCal Lipo team can address your buffalo hump, please fill out this online form to schedule a personal consultation. If you would like to reach us directly, please call us at (916) 347-7755.

Reasons Why a “Buffalo Hump” Forms

Diagram showing fat build up behind upper back.

Many people attribute a buffalo hump to bad posture. However, this isn’t technically the case. Bad posture can lead to a number of uncomfortable orthopedic conditions and compromise spinal health, but it has nothing to do with this fat deposit. A “hunchbacked” appearance can also be caused by an exaggerated curvature of the spine. This condition is known as kyphosis, and is colloquially referred to as a Dowager’s Hump. During your consultation at NorCal Lipo, we will be able to identify whether you do in fact have a simple deposit of fat, or if there are might be other underlying skeletal conditions that require attention. An accumulation of cervicodorsal fat has multiple specific causes. When deciding to undergo buffalo hump liposuction, it is important to note if one of these three might be the cause of your condition. 

Cushing’s Syndrome

While it is rare, Cushing’s Syndrome affects thousands of Americans every year. This condition occurs when the patient’s body produces too much cortisol over time, causing weight gain around the midsection, fat loss from arms and legs, and fatty tissue build-up around the face and upper back.[1] A significant trait from this disease is a buffalo hump at the base of their neck. This condition worsens over time. Minimizing the appearance of the buffalo hump with liposuction is a way to diminish the physical signs of Cushing’s Syndrome.

Weight Gain

As we age, we all gain unwanted fatty tissue in different areas of our bodies. Typically, these areas are more central to our body like around our midsection, legs, or hips. However, some of us are predisposed to accumulating fat around our neck and back. Since the buffalo hump is subcutaneous fat, the body is more resistant to burning it through diet and exercise. When the body utilizes stored fat for energy, it burns visceral fat first. Visceral fat is stored deeper inside the body and used when the body enters a caloric deficit. Subcutaneous fat, on the other hand, rests between the skin and muscle, and regulates heat loss in the body, among performing other important tasks. So, because it serves a purpose an essential role, the body is reluctant to burn it. This is why even after proper diet and exercise, a buffalo hump will still remain unaffected. 

Lipodystrophy From Medications

Since the development of highly active antiretroviral therapy (HAART), people with HIV and AIDS can live longer and healthier lives. While this treatment offers effective treatment, it also causes complex symptoms that include lipodystrophy:[2] a disorder where adipose tissue is abnormally configured on the body. This condition commonly causes loss of fat in the face, arms, legs, and buttocks, while depositing fat in the upper back, abdomen, and chest. Stopping essential medications for the sake of a cosmetic imperfection is not a healthy or practical option for patients with HIV. Therefore, liposuction to remove a buffalo hump is a practical solution. 

Benefits of Liposuction

When choosing between body contouring treatments, three distinct advantages come with liposuction. 

Simple Procedure

A liposuction procedure begins with light IV sedation that frequently used for other minor surgeries, such as wisdom teeth extraction. This outpatient procedure typically only requires a couple of hours to perform. After, you will be free to go home and focus solely on rest and recovery. With liposuction, patients can see immediate results that continually improve as swelling subsides. 

Easy Recovery

During a liposuction procedure, Dr. Friedlander utilizes tumescent fluid: a liquid that contains the local anesthetic lidocaine, saline, and epinephrine. This solution maximizes fat retrieval, minimizes blood loss, and mitigates trauma to the surrounding tissue. All these facets of tumescent fluid help shorten recovery time for the patient and enhance the sculpting results of liposuction. 

A Combined Approach

Patients with a buffalo hump typically have other areas of unwanted fat around their midsection, bra strap, or chin. Dr. Friedlander can treat all of these areas during one liposuction procedure. With this combined approach, patients only have to undergo surgery and recovery once. If you are interested in seeing how Dr. Friedlander and his team can reduce your buffalo hump, please schedule a personal consultation at our Roseville offices today!

Personal Consultation

If this is your first time at NorCal Lipo, we will begin your consultation with a brief new patient intake interview and a physical examination. We will then inquire about your desired aesthetic results. We will inspect your neck and upper back as well as any other areas of concern. When we examine your neck, we will need to make sure that the buffalo hump is caused by subcutaneous fat and not projecting bones, as is the case in patients with kyphosis. 

It is important to note that liposuction is not a weight loss surgery but rather a body contouring procedure, so we do ask our patients to be at a healthy, stable weight at the time of their surgery. If weight is gained after the procedure, results can be seriously diminished. During your consultation, Dr. Friedlander will review your medical background and note possible causes for your buffalo hump. Then, he will use this knowledge to construct a comprehensive, personalized treatment plan that addresses each one of your concerns. Before you leave our care, we will give you a list of preparatory steps that you should follow to ensure a successful surgery followed by optimal results. 


To prepare for your surgery, we recommend you follow these basic steps:

  • If you take any blood-thinning medications or supplements such as ibuprofen, Advil, or fish oil, we ask that you discontinue for a couple of days before your procedure and the entire duration of your recovery. If you are taking these medications under a doctor’s supervision, speak with your doctor before discontinuing. 
  • Plan a ride home. Even though you will be lightly sedated, you still won’t be fit to drive, so entrust a family member or friend to take you home and assist you.
  • Stop smoking a couple of weeks before your procedure. This includes all other nicotine products. Nicotine constricts blood vessels and hampers the body’s natural healing abilities. 


We begin your buffalo hump liposuction by making sure you’re comfortably relaxed before administering the appropriate anesthetic. Then, Dr. Friedlander makes a couple of small baseline incisions around the buffalo hump. He infiltrates the subcutaneous fat with tumescent fluid and then passes an aspirating cannula through the fatty tissue. A cannula is a thin tube that suctions out fat cells from the body. Because the tube is so thin, the incision required is small and typically doesn’t leave behind any significant scarring. Dr. Friedlander performs VASER liposuction. VASER liposuction uses a cannula that emits high-frequency ultrasound vibrations to release fat from its connective tissue to allow for more fat to be extracted in a less invasive procedure.[3] By passing the cannula through the fatty tissue evenly, Dr. Friedlander can shrink the size of the hump and bring the skin closer to the muscle. After he has eliminated the hump, he will suture the incisions. Once he has completed the procedure, you will be free to leave to focus on rest and recovery. 

Recovery & Results

Your treated area(s) will be sore for the next couple of days. It is important not to apply any undue pressure on the area, so please sleep on your stomach or sides for the next couple of nights. Take only the prescribed pain medication for any discomfort. At your follow-up appointments, we will note where you are in your recovery and determine if any next steps are needed. 

How Much Does Buffalo Hump Liposuction Cost in Northern California?

The cost of your procedure will be determined by the size of the hump and the different surgical techniques Dr. Friedlander uses during your procedure. We will discuss and determine the cost of your care during your initial consultation. If you are interested in financing your procedure, check out our financing page to learn about our options. To read past clients’ experiences, visit our reviews page, and read our blog for more information about the services we offer at NorCal Lipo. To reach us directly, please call our front desk at (916) 347-7755.


  1. Hoenig, L. J. (2021). The Buffalo Hump of Cushing Syndrome. Clinics in Dermatology. https://doi.org/10.1016/j.clindermatol.2021.08.018
  2. Abrams, H., & L., K. (2011). Novel Liposuction Techniques for the Treatment of HIV-Associated Dorsocervical Fat Pad and Parotid Hypertrophy. Advanced Techniques in Liposuction and Fat Transfer. https://doi.org/10.5772/22091
  3. Hoyos, A., & Millard, J. (2007). VASER-assisted high-definition liposculpture. Aesthetic Surgery Journal, 27(6), 594–604. DOI: 10.1016/j.asj.2007.08.007